Artikel
Microanatomy of the subcallosal artery in 7 Tesla magnetic resonance angiography: supposed clinical relevance for microneurosurgery
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Veröffentlicht: | 8. Juni 2016 |
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Objective: To investigate in-vivo microanatomy of the subcallosal artery branching from the anterior communicating artery (ACoA) using time-of-flight (TOF) magnetic resonance angiography (MRA) at 7 Tesla and its relevance for microneurosurgery.
Method: Eighty subjects, including 15 healthy volunteers and 65 patients, were included in this study. All subjects were prospectively evaluated utilizing a 7 Tesla whole-body MR system equipped with a 32-channel head coil between January 2011 and November 2015. Three raters identified branches from ACoA in maximum intensity projections (MIP) of TOF MRA at 7 Tesla acquired with 0.22 × 0.22 × 0.41 mm3 resolution. Anatomical variations in the course of the subcallosal artery, maximum diameter, as well as length and branching angle from the ACoA were assessed in sagittal MIP views (slab thickness 2.2 mm). Branching angles of subcallosal arteries from ACoA were measured in relation to the anterior commissure (AC) - posterior commissure (PC) line. Length of branching arteries was traced and measured as far as visible in the reconstructed sagittal MIP views.
Results: Branches from the ACoA were visualized in 68 of 80 (85.0%) subjects and were identified as the subcallosal artery (94.1%) and the accessory anterior cerebral artery (5.9%). In 12 subjects without vessels branching from ACoA, 7 subjects showed an artery originating from the proximal A2 segment running in front of the lamina terminalis to the rostrum and genu of the corpus callosum. Overall, in 75 of 80 (93.8%) subjects branching vessels running in the pericallosal cistern could be identified. The course of the subcallosal artery was classified into 3 groups; C-shaped (53.1%), straight (18.8%), and S-shaped (28.1%). The mean branching angle from ACoA in C-shaped, straight, and S-shaped course patterns were 38.1° (standard error of the mean (SEM) 3.8), -10.1° (SEM 3.5), and -30.8° (SEM 3.3), respectively. There was a significant difference between the branching angles of C-shaped and straight (p < 0.0001), between C-shaped and S-shaped (p < 0.0001), as well as between straight and S-shaped (p = 0.0026) course patterns.
Conclusions: High-resolution in-vivo 7 Tesla TOF MRA can delineate the microanatomy of the subcallosal artery, which has previously only been fragmentarily described in cadaveric studies. Three main variants of course patterns and branching angles from ACoA could be identified that have supposedly clinical relevance for microneurosurgery.